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8 ways to treat deep vein thrombosis
When most of us think of a serious medical emergency, we usually think of sudden events such as heart attacks, strokes or serious injuries from a car crash. But some threats develop quietly, with subtle symptoms that can take time to develop into a life-threatening crisis.
One such danger is deep vein thrombosis, a blood clot that forms deep within the body and can travel to the lungs, sometimes becoming fatal. And deep vein thrombosis doesn't discriminate. It can start in a young adult after a long flight just as easily as it can occur in someone in their 60s recovering from surgery.
Understanding what this condition is, why it occurs and how it's treated can help you prevent it or at least recognize warning signs in yourself or someone you love.
What is deep vein thrombosis?
Deep vein thrombosis, or DVT, occurs when a blood clot forms in a deep vein – most often in the legs, though it can also happen in an arm, explains Dr. Lawrence Hofmann, a physician and professor of interventional radiology at Stanford School of Medicine. The clot, or thrombus, is made of fibrin, platelets, white blood cells and some red blood cells.
When the clot remains in your limb, it can cause swelling, cramping, warmth, aching, skin discoloration and engorged surface veins, Hofmann says, "but when the blood clot moves from your legs to your lungs, it's called a pulmonary embolism and can be very dangerous and even life-threatening.'
While DVT is more common in people 55 and older, it "affects around 900,000 people each year in the United States" across a wide range of ages, says Dr. Scott Cameron, section head of vascular medicine at Cleveland Clinic.
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What causes deep vein thrombosis?
No single factor causes DVT. Rather, it usually results from a 'perfect storm' of three issues, Hofmann says. These include slowed blood flow (venous stasis), vessel wall injury (endothelial damage) and thickened blood (hypercoagulability). 'You don't have to have all three to get a blood clot, but the more you have, the higher the risk,' he explains.
These issues can arise from many situations, including "genetic disorders that make a person's blood thick," says Dr. Anahita Dua, a vascular surgeon at the Mass General Brigham Heart & Vascular Institute; as well as extended hospital stays, trauma, long periods of immobility like on a long plane journey or car ride, a recent surgery or pregnancy.
Lifestyle factors and medical conditions can also play a role. These include obesity, smoking, heart disease, inflammatory bowel disease and hormone therapies. 'Cancer is another major risk factor for DVT,' Cameron notes, because tumors and some cancer treatments can increase clotting activity in the blood. 'And once a patient has experienced a clot, their chances of recurrence remain elevated for up to 10 years,' Cameron adds.
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How is deep vein thrombosis usually treated?
Though DVT can be intimidating and its complications sometimes life-threatening, early recognition and treatment greatly improve outcomes. Symptoms like swelling, pain or warmth in one leg can lead to a diagnostic ultrasound and prompt initiation of treatment, which allows many patients to recover safely.
The cornerstone of treatment is anticoagulants, or blood thinners, which reduce the risk of new clots and help the body gradually break down the existing clot. 'The clot starts to dissolve based on enzymes produced by your vein wall,' Hofmann explains.
For clots that persist and cause ongoing swelling, procedures like angioplasty and stenting help doctors physically open the vein or remove the obstruction. Minimally invasive catheter-based procedures are also sometimes recommended, Cameron says.
Compression stockings, early mobilization and lifestyle interventions like weight management and avoiding smoking can also help treat or prevent DVT.
Ultimately, Dua says, "the care a patient with DVT receives is determined by where the clot is, how extensive it is, what caused it and if they can take blood thinners safely."
